Pictorial Case Study: Groin rash

The case: This 69-year-old obese diabetic man presented to the surgery with a long history of a rash affecting his groin. The rash was present bilaterally and extended onto his upper thighs and scrotum. It was occasionally itchy but most of the time did not bother him.

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Pictorial Case Study: Groin rash

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Pictorial Case Study: Groin rash

How do you explain this chronic, malodorous rash?